Sriman Swarup is a board-certified hematologist-oncologist and the cofounder of OncoNexus, an AI-driven oncology workflow platform focused on improving efficiency and care delivery. He also leads Swarup Medical PLLC, where he consults on clinical systems design, health equity, and digital health transformation. Practicing in rural Arizona, Dr. Swarup manages more than 3,000 patient encounters each year while advising startups and health systems on innovation and health care strategy. He writes about medicine, technology, and health care leadership at his website.
Physicians are taught to accommodate. A clinic runs behind. We stay late. A colleague calls out. We cover. Credentialing takes longer than expected. We send another document. An administrator needs another week. We wait.
Much of this is appropriate. Health care is complicated, and functioning organizations depend on people extending one another reasonable grace. But there is a point at which accommodation stops being professionalism and starts becoming an incentive.
I was …
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Physician credentialing delays should carry a consequence
I was halfway through reviewing what looked like an excellent locums opportunity when I realized the hourly rate was the least important number in the agreement. The compensation was strong. The schedule was flexible. Travel was covered. On the surface, it seemed straightforward.
But what ultimately determined whether the opportunity made sense had very little to do with pay. It had to do with clarity.
The difference between conversations and contracts
Locums conversations …
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Reviewing locum tenens agreements: Look beyond the hourly rate
As an oncologist, I’ve sat through the 24- to 48-hour EMR trainings that claim to prepare clinicians for new systems. They rarely do. The average physician still spends one to two days in technical onboarding and another month fumbling through screens before feeling comfortable. Versions vary wildly even within the same vendor, and every move to a new hospital resets the learning curve.
One night in a rural hospital, I watched …
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Why EMR usability is a patient safety issue
We tell ourselves documentation is for patient safety. For continuity. For protection. But let’s be honest. It’s for billing. And once you see that clearly, it is hard to unsee.
In training, I was taught that the note reflects the thinking of the physician. That it should tell the story of the patient and the rationale for each decision. But in practice, it does not. It is a tool for revenue …
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Why medical notes have become billing scripts instead of patient stories
